title: Evidence of improved milk intake after frenotomy: a case report.
abstract: Ankyloglossia (tongue tie) is a well-recognized cause of breastfeeding difficulties and, if untreated, can cause maternal nipple pain and trauma, ineffective feeding, and poor infant weight gain. In some cases, this condition will result in a downregulation of the maternal milk supply. Milk-production measurements (24-hour) for a breastfeeding infant with ankyloglossia revealed the ineffective feeding of the infant (78 mL/24 hours), and a low milk supply (350 mL/24 hours) was diagnosed. Appropriate management increased milk supply (1254 mL/24 hours) but not infant milk intake (190 mL/24 hours). Test weighing convincingly revealed the efficacy of frenotomy, increasing breastfeeding milk transfer from 190 to 810 mL/24 hours. Postfrenotomy, breastfeeding almost completely replaced bottle-feeding of expressed breast milk. This case study confirms that ankyloglossia may reduce maternal milk supply and that frenotomy can improve milk removal by the infant. Milk-production measurements (24-hour) provided the evidence to confirm these findings.
authors.affiliation: CNM, IBCLC, School of Chemistry and Biochemistry, Faculty of Life and Physical Sciences, M310, The University of Western Australia, 35 Stirling Hwy, Crawley, Western Australia 6009. cathygarbin@cathygarbin.com.
authors.forename: Catherine Peta
authors.initials: CP
authors.lastname: Garbin
authors.forename: Vanessa Susanna
authors.initials: VS
authors.lastname: Sakalidis
authors.forename: Lynda Maree
authors.initials: LM
authors.lastname: Chadwick
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Whan
authors.forename: Peter Edwin
authors.initials: PE
authors.lastname: Hartmann
authors.forename: Donna Tracy
authors.initials: DT
authors.lastname: Geddes
mesh_terms: D000072676:Ankyloglossia; D001942:Breast Feeding / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008035:Lingual Frenum / Q000473:pathology / Q000601:surgery*; D008297:Male; D008895:Milk, Human; D009056:Mouth Abnormalities / Q000175:diagnosis / Q000601:surgery*; D013391:Sucking Behavior / Q000502:physiology; D016896:Treatment Outcome
keywords: ankyloglossia; breastfeeding; frenotomy; frenulotomy; lactation; milk production; nipple confusion; tongue tie